Two weeks down, two weeks to go in Xela, so I guess it’s about time that I talk about my school here!

I chose this school relatively arbitrarily off of a list of programs my medical school already supported, and I’m so, so glad I did. My school, Pop Wuj, has been fantastic and exactly what I needed to learn medicine and Spanish simultaneously.

My afternoons are jam-packed with Spanish. Each day from 2-6 PM, I receive one-on-one language tutoring, which is fantastic, because my learning is tailored to my specific needs. Typically, we spend an hour on grammar, an hour on medical vocabulary, and the remaining time either reading Spanish stories aloud or conversing. I’m probably a really difficult student, because I tend to be pretty shy at baseline, so when you add in the constant struggle of a foreign language, I’m not super talkative. Regardless, I’ve been learning a ton and I can barely imagine where my Spanish will be in two more weeks!

My mornings, however, are way more fun. On Mondays and Thursdays, we have medical lectures on tropical disease, nutrition, or other common problems in Guatemala, while the other mornings are dedicated to clinic.

On Tuesdays and Fridays, we run clinic at our school. It’s a free clinic, and patients line up even before 7 AM to secure an appointment with the doctors. The clinic is set up and runs similarly to those in the US, but operates on donated medicines from an American NGO, so when the medicines run out, it’s time for Plan B. Students are responsible for triage (taking vital signs and getting a basic history) and consults (the actual patient visit) with the help of two Guatemalan physicians who are actually around the same age as me! I have to apologize for not having pictures of the school clinic yet… it’s a busy place!

This Wednesday, I traveled to mobile clinic in “Alaska.” Okay, so obviously, I didn’t really hop on a microbus to Alaska (would I even be there yet?), but that is the nickname of a small community called Xeabaj that was forced to rebuild its entire community after a hurricane several years ago:

Again, the poverty was palpable; we traveled down bumpy, dusty, motion-sickness-inducing roads to the middle of nowhere and held our clinic in a one-room concrete building:

…I’m not really sure why we left ONE chair in the middle of the room.

Here, we’re limited in medications (we were forced to prescribe an antibiotic that doesn’t cover skin bacteria super well for an abscess!) and privacy (lacking the ability to perform a pelvic exam, we had to treat a woman for both urinary tract infection and vaginitis). Working at a safety net hospital in the US sometimes feels like working with few resources, but this experience has been an incredible reminder that much can be accomplished with even less!

All in all, I was really proud of myself this week: I was able to get through all of my visits (along with my pediatric resident partner) with our intermediate Spanish levels. I’m confident by the end of my time here, I will feel confident enough to carry out a full visit on my own in Spanish. Mission (hopefully) accomplished!

Having completed my first week here, including a full day of simply wandering around the streets of Xela, I figure it’s time to share a glimpse of my life here (minus school, which I’ll talk more about later this week after I’ve had my first clinic). So, without further ado, here’s Xela in pictures!

My Xela home!

My room in Xela.

Typical street in Xela

Parque Central!

Main Cathedral

Because why wouldn’t you hang advertisements on the old beautiful church?

Just a pretty building we found…

La Democracia – a bustling, colorful market that sells anything you can imagine, including avocados bigger than my hand!

“Almuerzo economico” – Saturday’s lunch special!

Chicken buses!

Walmart really is everywhere..

View from Panorama – a restaurant overlooking the whole city!

Tomorrow will be my first actual clinic here, now that we’ve had several days of teaching on Mayan medicine and tropical diseases. More on that soon!

Yesterday, I had the opportunity to join my school on one of its social missions: to build safe stoves for the families of rural Guatemala. In many homes, families are cooking over open fires, which is problematic for a multitude of reasons. There’s the obvious fire hazard, along with the threat of respiratory disease due to smoke inhalation, and also the less obvious fact that an open fire doesn’t allow control of the heat, so much of it is lost, requiring more wood or other fuel to cook the same amount of food.

My school channels much of its tuition into buying the supplies for these stoves, and the students volunteer to provide the labor once per week.

The day began with my first chicken bus ride!

I have yet to take a good picture of a chicken bus myself, so here’s a stock photo!

Basically, a chicken bus is a school bus clad in colorful designs or cartoon characters jam-packed with native Guatemalans in local dress. I was kind of bummed because the one that we took was unfortunately just plain yellow, but I have to admit I never thought I’d be riding a school bus again!

As the bus headed farther and farther outside of the city, the change in socioeconomic status was visible. The scenery transformed from colorful storefronts and houses to dilapidated sheds without doors in fields of dust:

Our group of four arrived at a small little home barely larger than my bedroom in the US, which was home to a couple and their three sons, ranging in age from 1-6 years old. There were stacks of concrete bricks, sand, and concrete mix waiting for us, but we almost immediately ran into a problem: the family did not have a water source in their home.

Upon venturing across the neighborhood a few times to refill buckets of water at a neighbor’s house, we got to work: soaking the bricks so they would adhere to the cement. Mixing cement. Stacking the bricks in a precisely measured and leveled rectangle.

And my favorite job: chopping apart concrete bricks with a machete.

My handiwork!

In the end, we’d made this:

Our stage 1 stove! There are two more stages to be completed in weeks to come!

There’s no doubt that the extreme poverty of this family was striking, but what stood out even more is their generosity. While six year olds in America have no qualms asking for a laundry list of items for Christmas, the six year old in this house divided his single cookie into five parts: one for himself and each of four volunteers.

Why is it that people with nothing share so willingly, while people with everything hold on tight?

I can almost guarantee you this situation is happening in some hospital, somewhere, with some patient: the medical team walks in, asks a few simple questions in English, and gets the correct answers. The team then proceeds to explain the entire treatment plan in English, assuming that if the patient can respond to basic questions, they must have a grasp of the entire language.

My experiences this week have made me acutely aware of how dangerous this situation can actually be. When speaking to Guatemalans, I can demonstrate a reasonable grasp of Spanish, and often receive responses that are far more complex than I can fully understand. Sometimes, I just get the general gist of things. Other times, I make incorrect assumptions and miss the point altogether. Or worse, I may not have even the slightest idea what was said, but don’t feel comfortable enough (or can’t remember the words!) to ask them to slow down. But typically, I’m only trying to buy a bus ticket or understand my host brother’s new job, so a few words lost in translation are usually not a huge deal.

But when explaining a cancer diagnosis or the risks and benefits of a surgery, losing words in translation is not an option we can afford. I have no doubt there are patients for whom English is a struggle, but they may be too embarrassed or respectful to interrupt to remind us that they can only handle the basics. No wonder patients have difficulty complying with treatments, or even articulating what exactly their medical problems are.

Though I came to Guatemala to learn Spanish via cultural immersion, this trip is also a firsthand experience confirming the importance of using interpreters, avoiding assumptions, and checking to ensure patients are understanding their providers, regardless of language.

Yesterday, I was awake for 20 hours straight, a feat reminiscent of my surgery rotation. But at least this time, there was no pre-rounding, no vitals to be recorded, and no scrubbing into operations.

This time, I was waking up at 2:30 AM for this:

Even though it was cloudy (apparently normally, it’s also really foggy), there was something incredible about sitting at the top of a Mayan temple watching the sky change colors over the trees, with a chorus of colorful birds and howler monkeys around you. (Howler monkeys are unbelievably loud!!)

And thus began our trip to Tikal, an impressive Mayan ruin situated in northern Guatemala. If the above scene seems vaguely familiar, it’s because a similar shot is featured in Star Wars Episode IV… awesome!

The Temple of the Grand Jaguar (R) and the Necropolis, as viewed from atop Temple II, all within the main plaza.

Temple III, which you’re allowed to climb via steep steps that are far too high for short legs, but I climbed anyway!

Those are MY hands. Holding a tarantula. And nothing terrible happened.

These sprawling ruins are the remains of what was once the capital of a booming Mayan civilization, and features six very large temples among a collection of causeways, plazas, and the acropolis. Three restored temples may be climbed, while most other structures are closed to the public, although, shhh!: our guide let us step into one of the palaces, where we were greeted by bats!

After a long morning of exploring the ruins, we were grateful for a relaxing evening in beautiful Flores, a charming island town just an hour away from the ruins. How freaking cute is it?!

We stayed at Hotel Mirador del Lago – Viewpoint of the Lake!

Parque Central de Flores

All of the buildings are so colorful!

Tonight, I take off for Guatemala City and will catch a morning bus up to Xela, where I’ll make my home for the next four weeks. I’m so excited to meet my host family, visit the medical clinic I’ll be working in, and start really learning Spanish!

I’m covered in bruises and scrapes, to the point that it even hurts to sit.

And it was SO WORTH IT. I mean, look at this place:

Semuc Champey is one of the most beautiful places I’ve ever gotten to visit, and my day here was absolutely incredible.

We climbed slippery rock steps for 40 minutes to reach this viewpoint:

Then we jumped, swam, and slid down waterfalls in this gorgeous water:

We took a tour of the Kan’ba Caves, which was simultaneously awesome and terrifying. We were provided hand-held candles for lighting and climbed down a rickety ladder into the water below. At times, we were treading water with our candle hand held high, and at other times, we were clenching the candle in our teeth as we climbed a waterfall via a rope ladder. I think the most terrifying part, however, was when we had to drop into a hole with a waterfall pouring in and no view of the other side… just lower yourself, take a breath, and drop! (No pictures, because I wasn’t risking my camera in the cave, but click here to see the Google images…)

But we ended our day of adventure with the ultimate in lazy river rides, and cruised down the river in tubes.

Easily one of the most incredible days of my life. And tomorrow, it’s on to Flores so we can visit the Mayan ruins at Tikal!